Kenneth Gerard Fogal, MS VP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP0270 Issued in MN

Practice address

318 E Main St
Central Lakes Medical Clinic ,PA
Crosby, MN 56441-1691

Phone

(218) 546-8375

Fax

(218) 546-4400

NPI assigned

Dec 5, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104800960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 E MAIN ST",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411691",
            "telephone_number": "218-546-8375",
            "fax_number": "218-546-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 E MAIN ST",
            "address_2": "CENTRAL LAKES MEDICAL CLINIC ,PA",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411691",
            "telephone_number": "218-546-8375",
            "fax_number": "218-546-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGAL",
        "first_name": "KENNETH",
        "middle_name": "GERARD",
        "credential": "MS VP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP0270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Erickson, RD,LD,CDE
• Samuel T Feyder, PA-C
• Laura B Fier, MD
• Jeffrey Paul Fish, D.D.S.
• Matthew Francis Fleming, PA-C
• Brittany M Fox, PHARMD, MPH, BCPS
• Kristin Lynn Furan-Kriesel, PSY.D, LP
• Kendra Lee Gacke, PHARMD
• Gregory James Gavin, CRNA
• Jennifer A. Giza, PHARMD.

• Psychologist in Crosby, MN
• Providers in Crosby, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.